Rapid decrease in elastography results.

[Cornwall33]

Hello everyone, I finally decided to open this post . Last June I had a 2D-SWE test, with a result of 7.5 kPa, which is compatible with an F2 Metavir level.

I must say that my LFTs were not normal, with very high GGT levels. I had been drinking heavily for the previous few months (I was only supposed to have an ultrasound, but they added elastography at the same time). In addition, subsequent analyzes revealed the presence of EB and CMV antibodies. Negative for hepatitis A, B, and C antibodies. I had had COVID one month before, and was taking antibiotics due to sinusitis that I suspect was a side effect of COVID.

Ok, since I read that regular alcohol consumption can lead to overestimation of kPa, I stopped drinking, started doing exercise and drinking moderate amounts of coffee daily. I repeated the elastography in another health provider a month and a half later. My LFTs had completely returned to normal (so i wonder the reason of LFT increase was alcohol). In this occasion it was a TE by Fibroscan, a month and a half later, with a result of 4.6 kPa. The truth is I can not stay calm for some reasons:

- Could the first reading of 7.5 be overestimated, or the latter underestimated of 4.6? In this case it is a 2D-SWE test against a conventional Fibroscan (Echosens). Wich is more accurated?

- For the Fibroscan test, they used an XL probe 🙄. I am a thin person (BMI 21.8). I understand that the values ​​obtained with XL are lower, so the cutoff values ​​are lower, too. In any case, the diagnosis of the report was F0 and with a CAP of 180 a low score of steatosis (S0)

- Sometimes I would look at the equipment screen and, despite not being a health technician, I could see E values ​​of 9 kPa at some point during the test. In fact, I thought that my score would have worsened, and this made me nervous, but at the end of the test, the screen of the device showed a median of 4.6 kPa with an IRQ of 0.3. I didn't understand anything, although I felt relieved at the time. What is the point of seeing values ​​of that magnitude and then having a median of 4.6 kPa. In the report everything seems to be correct, 12 shots and 12 valid, with an IQR of 0.3.

In conclusion, I am confused about this result, in case it was wrong. How likely is this to happen?

Thank you all!

[MINTVCX]

Both fibroscan and 2D-SWE are ok to stage fibrosis level. You cannot say which is better although 2D-SWE seems to be better in some aspects. But no single test is enough to make final diagnosis.Your fibroscan result has IRQ/median around 6% which is very reliable value. There is a median value which is the final result. That's why any single result (value) is irrelevant. All scale is validated to median.

Please see hepatologist with all your results but I think you have nothing to worry about. Maybe you should think about your alcohol consumption.

[Cornwall33 in reply to MINTVCX]

Yes, since then I only had one day where I consumed. It seems clear that the origin of the problems is that. My doubts came from this apparently large difference between measuring with such in a short space of time.

I thank you very much for the reply! My best wishes.

🙂

[Roy1955]

The latest result is exactly what you hope for when you change your lifestyle!

That decrease is not rapid! It's exactly why you gave up drinking and it's working.

Keep it up.

[Cornwall33 in reply to Roy1955]

Thank you!

Of course, what worries me is that during the exploration I saw values ​​of 9 and even 10 kPa, but I don't know if that is a consequence of the movement of the probe towards other regions. The nurse told me to be calm. I expected a horrible result, even worse than the first time, I got a big surprise when I got up and saw the final result with 4.6 kPa and the report with the 12 shots images with its 12 values ​​all between 3.9 and 5 kPa and everything seemed normal to her.

Anyway, I have also read that the use of the XL probe gives lower values ​​than the M (which is the one that would correspond to me by BMI). Therefore, the cutoff values ​​are lower than for the M probe.

originalText.

According to this publication, mild fibrosis for XL probes starts from 5.5-6 kPa. In my case, it seems that I still fall below.

What I also guess is that an elastography should never be indicated until several weeks after the total alcoholic drinks abstinence.

[Roy1955]

It's 100% normal to have a range of readings mine were between 5 and 60!Thats why they take at least 10 and state the average as the final reading.

No single reading has any importance.

Yours are great!

[Cornwall33 in reply to Roy1955]

Ah!! Thanks! That is just what I needed to read!! ☺️

[pushthrough]

If I were you I would be celebrating!